Gastroenterology Coding Alert

Question:

Indiana Subscriber

If the gastroenterologist reports V76.51 (Special screening for malignant neoplasms; colon) or V76.41 (Special screening for malignant neoplasms; rectum), the lab is performing a screening. A screening FOBT uses the code 82270 (Blood,occult, by peroxidase activity [e.g., guaiac], qualitative; feces, consecutive collected specimens with single determination, for colorectal neoplasm screening [i.e., patient was provided 3 cards or single triple card for consecutive collection]).

In this case, he reports a known condition, disease, sign or symptom -- red-tinged stools (787.7, Abnormal feces) -- which should tell you the lab is performing a diagnostic test. Then you would report the procedure using 82272 (Blood, occult, by peroxidase activity [e.g., guaiac], qualitative, feces, 1-3 simultaneous determinations, performed for other than colorectal neoplasm screening).

Tip: You should use this code regardless of specimen collection method. The code allows "1-3 simultaneous determinations," so you may use the code for a digital rectal exam specimen or for a three-test card.